外科危重病人的营养支持

Nutritional support in critically ill patients of surgery

目的总结外科危重病人应用肠外营养与肠内营养支持的方法及经验。方法本组病例应用肠内营养（EN）支持26例，全部通过鼻肠管滴入安素或爱伦多溶液；通过中心静脉肠外营养（CV－TPN）50例，周围静脉肠外营养（PV－TPN）52例，均应用3升营养袋匀速滴入全合一营养液（TNA）。结果26例全胃切除术后病人应用肠内营养，无一例死亡及其他严重并发症。应用TPN组有3例死亡，死亡原因与TPN无直接关系。病人恢复快，平均住院无数缩短。结论由于外科危重病人存在独特的代谢特点，大部分病人存在营养不良，故营养支持对外科危重病人至关重要，直接影响病人的康复和预后。因此对外科危重病人应该进行积极的营养支持治疗。

objective To evaluate the method and experience for surgical critically ill patients using perenteral and enteral nutrition support. Methods In this series,26 cases were applicated enteral nutrition support, Ensure or Elental solution were dropped intestine in all patients by nasointestinal tube;50 cases underwent parenteral nutrition throught central veins (CV-TPN), 52 cases underwent parentera nutrition through peripheral veins (PV-TPN), all of the total nutrition admixture (TNA) were mixed thoroughly in PVC 3 liters package and infused into patients slowly. Results No death and other serious complications happened in 26 canses total gastrectomy with optoPerative enteral nutrition; 3 cases died in TPN group, not due to TPN. Nutrition status improved, patients recovered quickly,and hosptialization decreased apparently. Conclusions Nutrition supPOrt is important for surgical critical patients with malnutrition,due to their unique metabolic characteristics, affecting their convalesce and prognosis. Therefore, we advocate nutrition support should be given to surgical critical patients positively.